1/7. Influence of postural changes on the glomerular filtration rate in nephroptosis. The influence of postural changes on renal function was determined in 13 patients with nephroptosis and in 5 normal subjects by measuring GFR in the erect and supine positions. The result indicate that GFR was reduced in the erect position in 10 of 13 patients with either unilateral or bilateral nephroptosis whereas GFR was increased in the erect position in 4 of 5 patients without renal disease. One patient with bilateral nephroptosis and renovascular hypertension was studied before and after surgical correction of his disease. The observations indicate that patients with nephroptosis may have significant reductions in renal function when they assume an upright position, and suggest that GFR measurements in the supine and erect position in patients with nephroptosis can be helpful in evaluating this disease. ( info) |
2/7. Torsion of a visceroptosed spleen. Torsion of the pedicle of a visceroptosed spleen, a rare condition, was diagnosed preoperatively in a 4-year-old girl, with the aid of history, physical examination, blood smear findings, splenic scans with technetium tc 99m sulfur colloid, and selective angiography. A splenectomy was performed, and the child made an uneventful recovery. This case report illustrates some of the diagnostic and therapeutic considerations pertaining to torsion of the spleen. ( info) |
3/7. A peculiar multiple polypoid mucosal prolapse causing jejunal intussusception. A case of jejunal intussusception caused by a multiple polypoid mucosal prolapse of jejunum in a 10-year-old girl is reported. The rarity of the lesion, its location, symptoms, and diagnosis are discussed. ( info) |
4/7. Bleeding prolapsed hemorrhoids as a presentation of ruptured internal iliac artery aneurysm: report of a case. Internal iliac artery aneurysms (IIAAs) are rare and their concealed location in the pelvis presents a diagnostic challenge. We report a case of a 79-year-old man who presented 12 years after an abdominal aortic aneurysm repair, with signs of prolapse, bleeding, hemorrhoids, and a deep vein thrombosis. His condition rapidly deteriorated, with the development of acute renal failure and obvious perianal and perineal ecchymoses, within a few days. Abdominal ultrasound and computed tomography showed a ruptured IIAA. His renal function returned to normal after surgical decompression of the aneurysm. ( info) |
5/7. Hepatocolonic vagrancy: wandering liver with colonic abnormalities. Abnormalities of hepatic fixation resulting in excessive mobility in a transverse plane are uncommonly encountered. The unusual incidental finding of a freely mobile liver and spleen in a patient presenting with sigmoid volvulus is reported. At laparotomy, the inferior aspect of the right hemidiaphragm was smoothly peritonealized, without evidence of coronary or triangular ligaments. It is postulated that this abnormal hepatic mobility reflects persistence of the primitive ventral mesogastrium. To the authors' knowledge, this unusual condition has not previously been recognized. The literature relating to wandering liver is reviewed and four other cases are presented. An invariable association of persisting ventral mesogastrium with abnormalities in colonic anatomy (hepatocolonic vagrancy) is described. ( info) |
| Splenoptosis which is a congenital fusion anomaly of dorsal mesogastrium in children is a very rare entity. In the literature cases are usually diagnosed at operation and it is noted that in former years splenectomy had a special place among various methods of treatment. In this report, a 7-year-old case of splenoptosis diagnosed on ultrasonography and isotope scintigraphic methods preoperatively and treated by splenopexy is presented. In cases with splenoptosis the clinical and radiologic diagnostic criteria are given and the importance of splenopexy in treatment is emphasized. ( info) |
7/7. A case of transvaginal evisceration. We present a case of spontaneous evisceration of the small bowel through the vaginal vault in a 61-year-old women. The predisposing factors and management are discussed. ( info) |